Abstract 173P
Background
Therapy with PD1/PDL1 inhibitors of the immune checkpoints (ICI) has been the only significant advance for the treatment of ES-SCLC reaching the clinical practice within the past decades. Not every patient with this condition may be a candidate for these therapies due to clinical or regulatory reasons, so its impact in real-life patients may be limited.
Methods
We present a series of consecutive patients with ES-SCLC recently diagnosed in several hospitals of a north-eastern area of Spain and that received ICI (Atezolizumab, being the only IT reimbursed by the Spanish Health System at the present time for that indication).
Results
Between Jun/21 and Oct/22 206 patients (p) with ES-SCLC were treated in 8 hospitals. Of them, 61p received A (33.5%). Characteristics: Median age 61.0 years (39–81). Males 59.0%, PS 0/1/2: 36.1/49.2/14.7%, stage IV 98.4%. Median number of metastatic sites 2 (1–6) and the most common organs affected were: liver 52.5%, bone 52.5%, lung 26.2%, adrenal 26.2% and CNS 11.5%. LDH values were elevated in 58.5%, LIPI index was good in 23.8, intermediate 45.2 and poor in 31.0%. Compared to p not receiving IT, had better PS (0, 36.1 vs 17.6%, p = 0.004), were more female (NS) and had more liver metastasis (NS). No differences existed in other characteristics. Accompanying CT scheme was mostly Carboplatin-Etoposide (96.7%), Cisplatin-Etoposide given only to 2p. Median number of CT courses was 4 (1–6) and of IT 6 (1–17). Objective responses (52 evaluable p): complete 1.9%, partial 84.6%, stable ndisease 1.9%, progressive disease 11.6%. 25 p have already progressed (40.9%) and median time to progression was 20 weeks (w) (18–21 w). Second-line therapy was given to 17p (27.9%), mostly topotecan 9p (paclitaxel 5p, other 3p). RT was given to 22p: SNC 10p, bone 8p, subcutaneous metastases 1p, plus 5p receiving PCI. Survival tended to be worse in CNS metastases (18 vs 21 w), worse LIPI index (poor vs good: 20 vs 31 weeks), but no differences were found according to sex, PS, LDH or NSE levels. Median Overall Survival was 38w (29–46 w) with 43% of patients still censored.
Conclusions
These results, albeit early, may replicate those of clinical trials with IT in ES-SCLC, both in terms of patients’ characteristics and outcomes.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
A. Artal-Cortes: Financial Interests, Personal, Invited Speaker: Roche, MSD, BMS, AstraZeneca. All other authors have declared no conflicts of interest.